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Evaluation of the effectiveness of electroencephalographic training with neurofeedback (EEG-NFB) for a patient with dysexecutive syndrome after neurosurgery of two brain aneurysms detected after COVID-19 disease

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Morga R., Mirski A., Buczaj A., Pąchalska M.

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vol. 21(3)

279-303

EN

The purpose of this study is to evaluate the effectiveness of functional neuromarker- based electroencephalographic training with neurofeedback (EEG-NFB) for a patient with dysexecutive syndrome following neurosurgical operation of two brain aneurysms of the left and right middle cerebral artery (MCA) detected after COVID-19 disease. A right-handed, 56-years-old, not vaccinated, patient, became infected with SARS- CoV-2 and contracted COVID-19 with the manifestation of respiratory symptoms, high fever, dyspnea and low saturation of 79% Sa02. She was hospitalized at the Infectious Disease Unit, where a positive RT PCR test for COVID-19 was confirmed. The acute phase of COVID-19, during which oxygen therapy was administered, lasted two weeks and was complicated by brain fog and transient hypertension (175/100). There were no signs of focal damage to the central nervous system. She was discharged home in a good general and neurological condition. After returning home, the patient was unable to cope with daily functioning, as she said her brain fog continued to persist, manifesting itself as executive dysfunction. Eight weeks after the infection, the patient's neuropsychiatric condition worsened. On CT and MRI examination of the cerebral vessels, she was diagnosed with the presence of two aneurysms located on the left and right middle cerebral arteries (MCA). She was operated on at the Department of Neurosurgery and Neurotraumatology, where a pterional craniotomy and clipping of both brain aneurysms was performed. The Yasargil titanium clip was placed on the aneurysm neck. During the surgery procedures, performed two months apart, there were no signs of a history of subarachnoid haemorrhage and the post-operative period was uneventful, except for a drooping right-eye eyelid (after the second surgery) with a tendency to improve. Each time, the patient was mobilized and walked independently and was discharged home in a good general condition, with no neurological symptoms, except for executive dysfunction. Approximately five months after the SARS-CoV-2 infection (four weeks after the second surgery), her executive dysfunction worsened. Neuropsychological testing using Mindstreams™ Interaction Computer Tests revealed moderate Dysexecutive Syndrome (DES), while neurophysiological testing using qEEGs, ERPs and sLORETA tomography, a functional neuromarker of frontotemporal area dysfunction. The EEG pattern was characterized by excessive, slow (about 6 Hz) activity in frontotemporal areas, which indicated the progressive loss of cognitive control over time. The patient was offered an electroencephalographic training protocol with neurofeedback (EEG-NFB) based on the detected functional neuromarker, which reduced DES. The improvement achieved during therapy was statistically significant [compared to the normative database (Human Brain Index, HBI)]. In effect, the patient's quality of life improved, as she herself pointed out. Her symptoms of brain fog and DES disappeared and she returned to her previous work as a waitress. The Human Brain Index (HBI) methodology can be successfully used in the neurodiagnosis and implementation of individualized electroencephalographic training with neurofeedback (EEG-NFT) for patients with executive dysfunction after contracting longCOVID.

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NEURO-COVID: A PRELIMINARY REVIEW

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MacQueen B. D., MacQueen W. D.

Acta Neuropsychologica

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2021

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vol. 19(3)

389-402

EN

This article reviews some very recent publications pertaining to the long-term neuropsychological effects of COVID 19 (neuroCOVID). Although such publications are now appearing in large numbers on a daily basis, we still do not have enough data of sufficient quality to enable any firm conclusions to be reached. At this point, then, the authors determined to consider the main questions that have emerged so far, as we wait for the results of more thorough research in the future. The article takes up three main questions: (1). What is the etiology and pathomechanism of the neuropsychological symptoms caused by SAR-CoV-2 infection, and what is the prognosis? (2). Of the reported symptoms, which ones should be considered pathognomonic, and what is their significance? (3). What can clinicians do for their patients now, in the absence of the kind of data we need to answer either of the other two questions with any degree of certainty? Although it is not possible at this point in time to answer any of these questions definitively, it does seem increasingly clear that the problems are complex, not only at the cellular level, but also (and perhaps more so) at the conceptual level. The common report of “brain fog,” for example, very much needs to be explored, in order to determine what this vague term actually means, and what, if anything, can be done to allevi- ate it. This will require us to rethink such basic concepts as consciousness, and also to commit ourselves to genuinely interdisciplinary study.

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Neuropsychological consequences of COVID-19: current approach and clinical recommendations

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Treder-Rochna N., Witkowska M. A.

Acta Neuropsychologica

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2024

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vol. 22(1)

107-128

EN

Nearly two years into the pandemic, a large body of data has emerged on how COVID-19-positive patients function with the viral infection. It is now known that the virus targets the central nervous system(CNS). As a result, in addition to the expected common health complaints, patients display cognitive and emotional problems. Cognitive deficits should be expected particularly in patients who have arrived at an intensive care unit as a result of respiratory failure, in patients suffering from comorbid neurodegenerative diseases and respiratory conditions, as well as in the elderly. However, these may also occur in patients with moderate to mild symptoms as well as in those of a younger age. The cognitive impairment has an unknown profile. Given the hypothesised hippocampal vulnerability to the SARS-CoV-2 virus, one might expect particular difficulties with memory, attention, information processing, and executive functions. With varying neuropsychological and emotional problems, convalescents in trying to return to their social, family and professional life require professional psychological assistance. The role of neuropsychologists is here crucial. Indeed, many patients will require a detailed, multifaceted neuropsychological diagnosis that will form the basis for subsequent neuropsychological rehabilitation. An early detection of neuropsychological manifestations could modify the risk of subsequent irreversible impairment and further neurocognitive decline.

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Evaluation of the effectiveness of electroencephalographic training with neurofeedback (EEG-NFB) for a patient with dysexecutive syndrome after neurosurgery of two brain aneurysms detected after COVID-19 disease

NEURO-COVID: A PRELIMINARY REVIEW

Neuropsychological consequences of COVID-19: current approach and clinical recommendations